University of California, San Francisco, Department of Ophthalmology, San Francisco, California, USA.
Ocul Immunol Inflamm. 2011 Feb;19(1):32-8. doi: 10.3109/09273948.2010.520405. Epub 2010 Oct 31.
To determine the incidence of bacterial contamination of needles used for intravitreal injections.
Patients undergoing intravitreal injections were enrolled prospectively. No pre-injection antibiotics were administered. Following povidone-iodine irrigation, conjunctival cultures were taken and the injection was performed. The needle was cultured. A dry control needle was exposed to the surgical field and cultured.
No patients developed endophthalmitis. Eighteen injection needles (18%) yielded positive bacterial growth. The most commonly encountered organisms were Propionibacterium acnes (n = 8) and Staphylococcus epidermidis (n = 6). Four control needles showed positive growth, in 2 cases with the same organism as a matching positive used needle. The difference between contamination rates of used and control needles was significant (p = .002, McNemar's test).
Bacterial contaminants are present on a substantial proportion of needles. Since the needle contacts both the ocular surface and the vitreous, it is possible that inoculation of the vitreous cavity occurs in such cases.
确定用于玻璃体内注射的针头细菌污染的发生率。
前瞻性纳入接受玻璃体内注射的患者。未给予注射前抗生素。聚维酮碘冲洗后,进行结膜培养,并进行注射。对针头进行培养。将干燥的对照针头暴露于手术部位并进行培养。
没有患者发生眼内炎。18 个注射针头(18%)呈阳性细菌生长。最常见的病原体是痤疮丙酸杆菌(n=8)和表皮葡萄球菌(n=6)。4 个对照针头呈阳性生长,其中 2 例与匹配的阳性使用针头相同的病原体。使用针和对照针的污染率差异有统计学意义(p=0.002,McNemar 检验)。
大量针头存在细菌污染物。由于针头既接触眼表面又接触玻璃体,因此在这种情况下,玻璃体腔可能会接种。